School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.
Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia.
J Paediatr Child Health. 2021 Oct;57(10):1594-1599. doi: 10.1111/jpc.15548. Epub 2021 May 10.
This study aimed to investigate the variability by ethnicity, socio-economic status and location in coverage and testability of the universal B4 School Check vision screening in children aged 4-5 years in New Zealand.
Aggregated data from 1 July 2011 to 30 June 2015 were sourced from the Statistics New Zealand Integrated Data Infrastructure. Sourced data were attendance at vision screening and record of visual acuity measurement stratified by ethnicity, socio-economic status and region. Children who attended screening were compared with the eligible population (n = 252 279) to calculate coverage. Testability was determined by comparing the children with a recorded visual acuity measurement in each eye with those who attended screening.
Overall vision screening coverage was 89.5% and testability was 97.8%. Ethnic differences were evident for coverage (85.7% in Pacific children, 92.5% in European children) and testability (96.4% in Māori children, 98.4% in European children). Socio-economic differences were also observed for coverage (86.4% in most deprived areas, 92.4% in least deprived), testability (most deprived 96.3%, least deprived 98.7%) and by region (coverage range of 80.4-96.4% and testability range of 93.2-99.3%).
Significant disparities exist in vision screening coverage and testability for New Zealand pre-school children. Equity-focused initiatives are required to improve outcomes for children from Māori and Pacific families, and those from households in lower socio-economic areas. Understanding region-specific challenges and successes could support more equitable access to vision screening between regions. Further research is required to determine sources of inequities and to investigate interactions between ethnicity, socio-economic status and location.
本研究旨在调查新西兰 4-5 岁儿童普遍采用的 B4 学校视力检查在种族、社会经济地位和地理位置方面的覆盖率和可检测性的差异。
本研究从新西兰综合数据基础设施中获取了 2011 年 7 月 1 日至 2015 年 6 月 30 日期间的数据。根据种族、社会经济地位和地区进行分层，对视力筛查的出席情况和视力测量记录进行了汇总。将参加筛查的儿童与合格人群（n=252279 人）进行比较，以计算覆盖率。通过比较每只眼睛有记录的视力测量值的儿童与参加筛查的儿童来确定可检测性。
总体视力筛查覆盖率为 89.5%，可检测性为 97.8%。覆盖率方面存在明显的种族差异（太平洋岛民儿童为 85.7%，欧洲儿童为 92.5%），可检测性方面也存在差异（毛利儿童为 96.4%，欧洲儿童为 98.4%）。社会经济地位方面也存在差异，包括覆盖率（最贫困地区为 86.4%，最不贫困地区为 92.4%），可检测性（最贫困地区为 96.3%，最不贫困地区为 98.7%）以及地区差异（覆盖率范围为 80.4-96.4%，可检测性范围为 93.2-99.3%）。
新西兰学龄前儿童的视力筛查覆盖率和可检测性存在显著差异。需要采取以公平为重点的举措，以改善毛利族和太平洋岛民家庭以及来自社会经济较低地区家庭的儿童的结果。了解特定地区的挑战和成功经验可以支持在各地区之间更公平地获得视力筛查。需要进一步研究确定不公平的原因，并调查种族、社会经济地位和地理位置之间的相互作用。
